Woman may experience three types of sexuality problems in her married life.

These problems could be pertaining to sexual desire, sexual arousal or in enjoying orgasm i.e. sexual climax.

Although in most loving couples desire is followed by arousal which is followed by climax, these three could exist independent of each other.

Woman can be sexually aroused even without feeling any sexual desire. Sometimes she may feel angry on herself for getting aroused.  Similarly orgasm may occur even without arousal.

Difficulties in any one of them could disturb loving relation. The problem could be primary, which existed from the time the sexuality began or secondary i.e. occurring later in life.

The sexuality may be disturbed due to physical reason like hormonal problem, or psychological or because of both occurring simultaneously.

Individuals taking Pre-Marriage Guidance will know more about mechanism of sexuality of man as well as woman.

This will help them in cultivating sexuality of themselves as well as their partner. They will also be able to identify the problems in time and handle them accordingly with appropriate assistance from their Doctor.

Normally woman should not get pain during intercourse, if she is sufficiently aroused and her vaginal passage is well lubricated and sufficiently lengthened with increased elasticity to accommodate an erect penis

However, in certain other cases also she may find intercourse painful. The intensity of pain may vary from mild discomfort to excruciating pain.

One must avoid home remedies or self medication including application of lubricant.

Issue of insufficient arousal must be ruled out as the cause.

Advice of a Gynaecologist is indicated to diagnose or rule out any of the following problems and get it treated in time,

1.   Insufficient Vaginal Lubrication (hormone issue)

2.   A Vaginal or Pelvic Infection

3.   Recent Childbirth

4.   Involuntary tightening or spasm of vaginal muscles resisting insertion
(Vaginismus)

5.   Endometriosis

6.   Fear psychosis

If a woman’s vagina is very dry, she may find intercourse extremely uncomfortable and even painful. The soreness may remain even after intercourse because of which woman may develop dislike or hatred towards intercourse.

Most common reason for insufficient lubrication is inadequate stimulation or insufficient arousal before intercourse.

Vaginal passage is usually dry except during menstruation.

When the woman is aroused sufficiently her vaginal walls get well lubricated by the secretions within the vagina. The length of the vaginal passage gets lengthened at least by two inches to accommodate the erect penis.

This problem can be easily solved if the husband is made aware of this natural process in a woman. Use of lubricants may not resolve the pain because the insufficient lengthening of the vaginal passage may still cause pain and discomfort.

Such dryness of vaginal passage may also be common during or after the menopause. This may be due to insufficient levels of female hormone like estrogen.

Use of water soluble lubricating gel such as K-Y Jelly may help here. Never use Vaseline or any oily substance just because it is easily available at home.

 Care should be taken to use only water soluble lubricant else there is risk of harming the delicate vaginal tissues.

Avoid self medication and take help of doctor to rule out any other medical issue.

Advice should be taken from the Gynaecologist to check if ‘Hormone Replacement Therapy’ is indicated.

The most common problem of getting Sexual Climax or Orgasm is not getting the orgasm.

While some women do not know anything about climax or orgasm, some women never experience a climax.

Some women get orgasm while self pleasuring, but have never experienced it while making love with husband. These women are less likely to enjoy sex and have lower desire for sexual intimacy.

Getting orgasm also depends largely on partner’s knowledge about woman’s sexuality and skill to stimulate her passionately as communicated by her.

It is equal responsibility of woman to learn sexual communication and ensure that she gets the desired pleasure of climax.

Sometimes body responds to certain fears which lead to refusal to sex as a reflex action, without woman actually meaning to hurt her husband.

These fears may be fear of pregnancy, fear of pain on intercourse or pain due to excessive thrust of penis on previous occasion. These fears may be worsened by lack of sexual arousal from husband.

This refusal for sexual intercourse creates serious issue in married life where sexual life of both partners is at risk.

This condition is quite common among newlyweds having no sexual experience before marriage.

Understanding partner can resolve this issue effectively with patience and loving approach, without getting upset, irritated or dejected.

Pre-Marriage Guidance can help both in preventing this issue.

In most cases, a woman can get rid of fear of pain on intercourse, by exploring her sexuality through self pleasuring, and learn to understand pleasures of orgasm by stimulation of clitoris.

Couple should not hesitate to take medical advice at the earliest.

Problem in getting Orgasm is usually psychological, and in most cases it is made more complicated by ignorance, impatience or indifference of husband.

However, couple must take advice of a Gynaecologist, to rule out any problem with mechanism or physiology of sexual orgasm.

This can be done even before marriage by checking hormonal level as well as by proper Pre-Marriage Guidance.

For married couples, it is never too late. They should consult doctor in time, instead of accepting it as ‘normal’ occurrence and lead frustrating married life for both.

Most men feel that sex by vaginal penetration is as pleasurable for woman as it is to a man. Hence, they focus on man-on-top or missionary position and try to give their best performance.

However, in this position the clitoris which is main source of getting orgasm remains almost untouched, depriving her from real sexual pleasure.

In this man-on-top sexual position, there is little or no pressure or direct contact of the tip of the erect penis with most sensitive front wall of vagina.

Communicating your sexual feelings and preferences to husband will make your husband understand woman’s sexual physiology better. Then, by participating in sexual activity assertively with mutually pleasurable sexual acts and positions can easily solve this issue of climax.

The main difference between the orgasm of man and a woman is that woman can have multiple orgasms, one after another, if the sexual stimulation is continued.

Man, in contrast, has only one climax, that too is associated with ejaculation. Thereafter, he loses the erection and requires time before he gets another erection.

At younger age during twenties and thirties, the time gap is negligible, ranging between few minutes to couple of hours.

Whereas, in a man between fifties and sixties, the gap required may be from several hours to couple of days.

The woman faces most problems of orgasm when man stops stimulating his wife or is unable, or loses interest in getting further involved with her sexually after his ejaculation.

Or this reason it is recommended to let the woman reach her peak of sexual pleasure first and then the man should ejaculate so as to make the woman enjoy love making.

Apart from pleasure from stimulation of clitoris, woman also needs to see her man being successful in sexual intercourse.

Man’s ability to hold the strong erection for considerable time till intercourse is sufficiently enjoyed by both is as essential as his ability to control the time of ejaculation.

Woman may lose her interest in sex if the frequency of failure is more or when there is least predictability of success.

Man as well as woman may end up sympathising each other than giving sexual pleasure.

With timely advice from doctor, most problems of male sexuality can be treated successfully.

Men as well as women who have taken Pre-Marriage Guidance are less likely to face these situations and more likely to resolve them with confidence. 

Sexual arousal of woman leads to rushing of blood throughout the body, leading to series of effect on her body. There is generalized increase in body warmth, skin becomes more sensitive and responsive, and brain looks for every sexual signal. Depending upon the situation, the muscles in the body get into spasm like movements.

Woman responds to her husband by mutually stimulating actions.

Corresponding to arousal in man by erection of his penis, woman gets her vaginal passage well lubricated to facilitate insertion and movement of erect penis.

Simultaneously there is also lengthening of vaginal passage to accommodate the large penis.

Absence of lubrication of vaginal passage during love making is prime indicator of problem of sexual arousal.

Lack of lubrication can cause pain during intercourse, ranging from mild discomfort to severe pain.

In most cases the problem of arousal is because of disturbed relationship. It can also be due to absence or lack of sexual desire. In both cases, well informed husband can usually identify the real cause and find the solution.

If the problem persists in spite of cordial relationship between both the partners, advice of Gynaecologist is indicated.

In the absence of arousal, one should never use any lubricant, because the pain on intercourse will still be present because of insufficient expansion of vaginal passage and inadequate increase in elasticity of its muscular wall.

Use of any cream will also mask the real reason for absence of lubrication.

Use of water soluble KY Jelly may be recommended in cases where woman is fully aroused but the couple needs additional lubrication to facilitate intercourse.

Water soluble jelly will be thrown out of the vagina easily along with other vaginal discharges, while creams that are not water soluble may remain inside and cause irritation of vaginal wall.

In some woman there may be reduction or absence of lubrication even with their usual desire and excitement for sex. This may be due to disturbance in release of sexual hormone estrogen.

Doctor may recommend use of KY Jelly, a water soluble lubricant, to facilitate intercourse along with ‘Hormone Replacement Therapy’ if indicated.

Woman may have absence of sexual desire or very low sexual desire or very high sexual desire.

In married life the problem of sexual desire is most commonly seen when woman is unable to express anger towards her husband.

Feeling of being neglected by her husband, feeling of being unwanted when children separate, illnesses in the family, or too much of financial worries also contribute to loss of sexual desire.

Sometimes these factors are not primary but become triggering factors which have their origin in a variety of childhood or pre-marriage experiences.

Temporary absence of desire could also be due to hormonal imbalance, which could also happen at any age but more commonly observed during peri-menopausal period or after menopause.

Like appetite, there are individual variations in sexual hunger too. There will also be likes and dislikes for no specific reason. These likes may even keep changing with experience. Hence, exploring partner’s likes and dislikes is a continuous task in a long term loving relationship.

Lower sexual desire in one of the partner is possible for various reasons, but it is less likely to affect sexual relationship as such. But, loss of sexual desire by one of the partner can ruin the married life.

In rare condition, called nymphomania, woman may feel excessive and compulsive need for sexual intercourse. This term was more applicable in the era when women were not supposed to be even asking for sex.

In modern times when men as well as woman can have equal sexual desire and need, it would be unfair to call woman ‘nymphomaniac’ just because she is more assertive.

Today, self pleasuring being socially approved, women who explore their sexuality well before marriage, become equal or more assertive partners in sexual relationship.

It will be wrong to label a woman as a ‘low desire’ person just because she has lesser desire than her husband. At the same time it is wrong to call her a ‘high desire’ woman just because her sexual desire is more than him

It is also observed that women have more sexual desire in their thirties and forties, while most men slow down during this period.

Men unaware of this physiology, feel threatened by this sudden sexual dominance.

Therefore, in married life, it is as much important for both to cultivate sexual desire, as it is to control it to match that of the spouse.

Vaginismus or the spasm of vaginal muscles is another common problem of women which can disturb her sexual relationship.

As the attempt is made to insert the erect penis, the muscles around the entrance of the vagina go into spasm, i.e. contract quickly to close the opening of vagina, making intercourse impossible.

Many women, who face this problem, are sexually responsive but still bear fear of penetration of penis.

In such situation more the couple attempts to insert the penis, more painful it is for woman, and tighter becomes the opening.

This may be result of her reluctance to have sex usually due to one of the following reasons

1.   Has been brought up to believe that ‘sex is sin’, even with husband

2.   Influenced by friends telling that intercourse is a nightmare

3.   Is scared of becoming pregnant

4.   Forced marriage (never wanted to marry, or marrying against her choice)

5.   Unhappy with husband or hates him

6.   Had unhappy experience of sex

7.   Was sexually abused, molested or raped

Vaginismus can be treated successfully in most cases.

Woman may be deprived of orgasm also when she faces condition called Vaginismus, where the outer third of the vaginal passage contracts suddenly and blocks the entry of an erect penis.

This is usually due to ignorance, fear or hatred towards sexual act. The causative reason may be in upbringing, parent’s disturbed family life, or any kind of sexual abuse in the past.

Vaginismus could also happen if she has undergone clumsy medical examination of the vagina during younger age.

Woman may also get Vaginismus, when she gets pain due to forceful insertion of penis, by her husband, without ensuring sufficient lubrication of vaginal passage.

If timely advice is not taken from the gynaecologist, frequent experiences of Vaginismus may lead to loss of sexual desire and can affect marital relationship.

In such cases, getting or enjoying orgasm becomes impossible.

Vaginismus can be treated successfully in most cases.

If a woman if finding tensed about intercourse, especially during initial days of her marriage, she could face very embarrassing situation right from spoiling her ‘First-Night’ to Honeymoon. This will have serious repercussions in her married life.

In situations where husband is not understanding or accommodating type, situation will be even worse.

If your problem is only fear of insertion of penis, you would have it before marriage. Hence, you will have sufficient time to take advice of your Gynaecologist and learn the special exercise from the doctor in advance.

Following exercise would help 

• Cut your finger nails and wash your hands thoroughly
  
  
• With the help of mirror observe your genital area well. Spread the lips of your vulva apart to see the vaginal opening
  
  
• Touch the opening of vagina with your finger
  
  
• Lubricate your finger, with recommended cream (water based K-Y Jelly) and insert the finger little into the vagina
  
  
• Move tip of your finger inside vagina, as if you were trying to remove something out of your vagina. This movement of finger will loosen your vaginal muscles
  
  
• Keep your finger inside vagina for few minutes to make you comfortable with the feeling
  
  
• Then move it in a little more inside and tighten your vaginal muscles to take grip of your finger and then relax
  
  
• Repeat tightening and relaxing vaginal muscles several times and try to insert your finger as much inside as you feel comfortable
  
  
• Do this few times in a day or night whenever you get time
  
  
• Once you feel comfortable in holding and gripping one finger inside vagina, repeat the same exercise with two fingers into your vagina
  
  
• Try doing this exercise with your husband. He should clean his fingers, then lubricate them well and insert them as much inside as you wish to allow.
  
  
• If you are aroused and feel your vaginal walls wet, then vagina is already lubricated. Then, no other lubrication is indicated or needed
  
  
• Try intercourse when you feel relaxed and ready for inserting his erect penis. Have sexual position of your choice and take help of your husband to control the depth of insertion
  
  
• To start with do not have vigorous to and fro or up and down pelvic movements. Focus on gripping the penis with vaginal walls and relaxing them. Repeat the insertion couple of times
  
  
• You will feel your vaginal muscles relaxed enough to receive the insertion of penis

Patience and cooperation of partner is the best way to overcome this common problem of women.

Although clitoral stimulation is the easiest way for woman to get orgasm, she can get different but equally good sexual satisfaction from vaginal intercourse.

Men, who tend to focus on vaginal intercourse, generally have impression that she must be getting sexual pleasure equal to his.

Hence, woman who is aware of vaginal pleasures can get the best even out of casual sexual intercourse, till she is able to communicate her sexuality.

All sexual orgasms are self-generated and independent of partner’s involvement. Sexual pleasure with a partner whom you love is the key to build loving relationship in long-term marital life.

Learning to get vaginal orgasm can help a woman in getting pleasure also from sexual intercourse rather than depending only on outside stimulation.

Once you are comfortable with getting pleasure by stimulating your clitoris, you may try inserting your fingers into the vagina, while continue to stimulate clitoris with other hand.

Initially you may find no sensation inside vagina, because genital sensation develops with repeated contact and by learning to feel for pleasure.

You can opt of sexual fantasy of your choice without any inhibition or guilt, and may imagine your fingers as erect penis to get nearer to the pleasurable moment.

Gradually you will find the muscles in and around the genital area respond in an orgasmic way.

As the vagina gives more sensual feelings, it will lubricate more. You can then move your finger inside the vaginal passage to feel the responses of outer rim of vaginal opening as well as for exploring most pleasurable spots along the vaginal wall.

When orgasm takes place due to vaginal stimulation, it will be more through muscular contraction when inserted penis touches sensitive areas on wall of the vagina. This pleasure is different from the electric waves experienced in clitoral climax.

Learning how your body works sexually can help you in getting the desired pleasure while making love with your husband.

You can feel his erect penis in place of your own fingers and try to get the same pleasure.

Sexual pleasure in married life comes not only by loving your partner, but also by enjoying life time process of exploration and experimentation.

Treatment primarily involves counselling to develop acceptance to man and the sexual intercourse.

Then various methods can be advised for muscle relaxation like,

• Pelvic Floor Exercises (To learn the control of muscles in pelvic region including that of Vagina)
  
  
• Dilating vaginal opening by fingers or a vaginal dilator as per advice of the Gynaecologist
  
  
• Taking help of husband will help the woman recover fast from this problem.